Clinical follow-up of staged hybrid approach for patients with ventricular septal defects combined with patent ductus arteriosus and pulmonary hypertension
10.3760/cma.j.issn.0253-3758.2011.02.009
- VernacularTitle:室间隔缺损和动脉导管未闭合并中重度肺动脉高压的分期复合治疗
- Author:
Jian YANG
1
;
Li-Fang YANG
;
Jin-Cheng LIU
;
Shi-Qiang YU
;
Jian ZUO
;
Zhen-Xiao JIN
;
Tao CHEN
;
Ding-Hua YI
;
Jun ZHANG
;
Jun LI
Author Information
1. 第四军医大学西京医院
- Keywords:
Heart septal defects,ventricular;
Ductus arteriosus,patent;
Heart catheterization;
Cardiac surgical procedures
- From:
Chinese Journal of Cardiology
2011;39(2):128-131
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of staged hybrid approach in treating ventricular septal defect (VSD) patients combined with patent ductus arteriosus (PDA) and pulmonary artery hypertension (PAH). Methods From July 2004 to July 2009, 22 VSD patients with PDA and PAH were enrolled and received staged hybrid approach treatment( transcatheter PDA occlusion and elective open surgery for VSD several lays after PDA occlusion). All patients were followed up to examine rhythm change,residual shunt, shape of occlude, possible valve regurgitation, and aortic stenosis by echocardiography. Results After transcatheter PDA occlusion, pulmonary arterial systolic pressure decreased from (76. 2 ± 25. 8 ) mm Hg ( 1 mm Hg = 0. 133 kPa) to ( 55.4 ± 20. 6 ) mm Hg ( P = 0. 005 ),mean pulmonary artery pressure decreased from ( 53.5 ± 23.5 ) mm Hg to ( 36. 2 ± 17. 8 ) mm Hg ( P=0. 049), total pulmonary resistance decreased from (8. 2 ±4.9)wood units to (6.9 ±4. 3)wood units (P =0. 037), and pulmonary-to-systemic flow ratio (Qp/Qs) increased from 2. 8 ± 2. 3 to 3.4 ± 1.7 ( P = 0. 045 )post transcatheter interventional PDA occlusion. After VSD repair, pulmonary arterial systolic pressure decreased from (64. 5 ± 22. 3 ) mm Hg to (43. 1 ± 18. 9) mm Hg ( P = 0. 001 ) and mean pulmonary artery pressure decreased from (40. 2 ± 18. 7 ) mm Hg to (29. 5 ± 15. 8) mm Hg ( P = 0. 040). There was no death or right heart failure during the follow-up. Conclusion Staged hybrid approach is an effective and safe strategy for treating VSD patients with PDA and PAH.
